The mediating effects of resilience and the symptoms of depression and anxiety on social frailty and quality of life in older heart failure patients

Objectives: To investigate the relationship between social frailty (SF) and quality of life (QoL) in older heart failure individuals and to verify the mediating effect of resilience and the symptoms of depression and anxiety (DA) on this relationship. 

Methods: A cross-sectional study was implemented to collect data from 443 old HF patients from three tertiary hospitals based on convenient sampling. The measurement tools included a general information questionnaire, the Social Frailty Scale, the 10-item Connor-Davidson Resilience Scale, the Hospital Anxiety and Depression Scale, and the Minnesota Living with Heart Failure Questionnaire. The SPSS PROCESS Marco Plug-in was used to conduct mediation analysis. 

Results: The regression analysis showed that place of residence, the number of hospitalizations, and New York Heart Association (NYHA) classes were influencing factors of the QoL in older HF patients. The mediation analysis indicated that resilience and the symptoms of DA mediated the relationship between SF and QoL in older HF individuals, with mediating effect sizes of 45.95 % and 64.94 %, respectively. 

Conclusion: SF was significantly associated with QoL in older HF patients, and resilience and the symptoms of DA mediated the relationship. Interventions paying attention to reducing SF and the symptoms of DA or enhancing resilience are beneficial for improving the QoL in older HF individuals.